How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $181.97 Median $3,548.13 Typical High $7,585.78 | Facility | None | $181.97 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $181.97 Typical High $208.93 | Professional | None | $109.65 | $181.97 | $208.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $3,630.78 | Facility | None | $380.19 | $776.25 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $223.87 Typical High $354.81 | Professional | None | $107.15 | $223.87 | $354.81 |
CareSource Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $154.88 Typical High $426.58 | Facility | None | $109.65 | $154.88 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $204.17 Typical High $363.08 | Professional | None | $123.03 | $204.17 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $218.78 Typical High $302.00 | Professional | None | $114.82 | $218.78 | $302.00 |
Oscar Health Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
United Setting Facility Modifier None Typical Low $79.43 Median $158.49 Typical High $1,778.28 | Facility | None | $79.43 | $158.49 | $1,778.28 |
United Setting Professional Modifier None Typical Low $112.20 Median $204.17 Typical High $407.38 | Professional | None | $112.20 | $204.17 | $407.38 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $89.13 Typical High $104.71 | Professional | 52 · Reduced service | $54.95 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $35.48 Typical High $41.69 | Professional | 53 · Discontinued | $21.88 | $35.48 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $134.90 Typical High $154.88 | Professional | 54 · Surgery only | $81.28 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $26.92 Typical High $30.90 | Professional | 55 · Aftercare only | $16.22 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $17.78 Typical High $20.89 | Professional | 56 · Pre-op care only | $10.96 | $17.78 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $125.89 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $75.86 | $125.89 | $144.54 |
Where Georgia sits
The same service costs 3.5 times more in Alaska than in New Jersey. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Georgia· 16th of 51
$209
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.